possible blood pooling, and in most cases, a visible deformity that leaves the athlete completely unable to walk. Third degree sprains can only be fixed by surgery, although massage may speed recovery post-surgery. For first and second degree ankle sprains, cross fiber friction will be the primary technique used to treat this injury, since it helps break down scar tissue as well as helps it from reforming while helping to realign existing connective tissue. To apply cross fiber friction at the ankle, massage therapists should first make sure that the client is in a comfortable position, which may be either sitting or lying face up, or even lying prone with the feet hanging off the end of the massage table, if that is the most comfortable position for them. Next therapists should check for inflammation or swelling; they will want to apply ice to the injury site first if there is even a small amount of inflammation or swelling present. Once therapists are sure that the acute stage of the injury has passed and there is no inflammation or swelling, they can apply cross fiber friction near the site of the injury and work slowly towards it, along the length of the injured ligament. Therapists should use as much pressure with the friction that does not cause athletes to feel too much pain. Too much pain leads to muscle guarding which will lead to pressure on the ankle ligaments Broken clavicle This common fracture occurs when an athlete falls onto the shoulder or an outstretched hand and more force than can be withstood is transmitted to the collar bone. The resulting injury is sometimes accompanied by an audible popping or snapping sound, is immediately painful, and felt somewhere between the neck and the acromioclavicular joint (the AC joint) where the clavicle meets the scapula’s acromion. On occasion, the clavicle will appear deformed or out of place. The pain of this injury typically becomes worse when the athlete tries to move the upper arm through virtually any plane of movement. As with most broken bones, inflammation or blood pooling may accompany the injury. Any type of massage done for the clavicle that goes beyond light pressure that is meant to assist or stimulate blood flow to the area of the injury should not be done until the bone is well into its mending phase, usually at least a month after the injury for adults. (Recovery times vary depending on the severity of the break and how much the athlete continues to use the upper arm.) With the injury well into the mending phase and any inflammation or swelling subsided, massage therapists will want to implement cross fiber friction first, as this will reduce scar tissue as well as prevent new scar tissue from forming. Regardless of where the fracture of the clavicle occurred, therapists will want to start cross fiber friction on the clavicle at the AC joint and work along the clavicle towards the neck. As always, massage therapists should work within the athlete’s Cervical (neck) injuries Given the number of neck muscles involved in supporting and moving the head, sprains and strains involving the neck and cervical spine are common in contact sports. In fact, neck injuries involving the cervical spine account for more than half of all career-threatening injuries. As athletes become bigger and stronger, there is ample opportunity for neck muscles to become overloaded or overpowered by outside forces. Usually, these outside forces are other players who, in colliding with another athlete, can cause an overextension or over-flexion of the head in any number of directions. On occasion, athletes can injure themselves by causing compression on their own vertebral column, such as in the case of high platform divers when their head comes in contact with the water. There are five muscles/muscle groups that are typically involved in neck sprains and strains in athletes. They are the sternocleidomastoid (SCM), scalenes group, upper trapezius, levator scapulae, and the suboccipital muscles. This course reviews the techniques for each muscle separately. The SCM, which rotates the head to the opposite side and assists flexion and lateral flexion of the neck, originates at the lateral portion of the sternum and the medial third portion of the clavicle and inserts at the mastoid process behind the earlobe.
causing more pain. Therapists should continue the cross fiber friction for up to 10 minutes, then check for inflammation or swelling; if present, apply ice and discontinue massaging the ankle. Then, therapists should not reapply cross fiber friction until at least 24 hours have passed. Additional treatment and prevention Rest, ice, compression, and elevation (RICE), NSAIDs, and Kinesio taping can help ease the pain and inflammation associated with ankle sprains. Massage therapists may recommend to athletes that they wear an ankle support if they are not doing so already. Athletes should not resume their sport until the injury is completely healed (depending upon the degree of the sprain, anywhere for a few days to months) or the condition will worsen. Once recovered, athletes may want to incorporate a balancing device known as a wobble board into their training program, which will help them regain their strength and increase their stability at the ankle. According to the American College of Sports Medicine, ankle sprains account for more than half of all sports injuries. This injury is most common among runners, followed by football players, basketball players, soccer players, and tennis players. tolerance for pain, remembering that the pain threshold will decrease as therapists approach the site of the break. If the site of the injury is too sensitive to pain, therapists should work as closely as they can to it. They may also use ice to numb the area near the injury. However, if the athlete has already indicated that working the injury site is too painful, therapists avoid direct pressure on that area; it may cause further damage otherwise. Having worked the clavicle itself, therapists may want to perform cross fiber friction along the upper one third of the sternum to loosen any restrictions there that may have occurred from the body trying to stabilize the injury. Because muscles surrounding an injury tend to become tense, massage therapists may also want to massage the pectoralis major and the neck muscles such as the sternocleidomastoid (SCM), scalenes, and upper trapezius with some simple effleurage or petrissage on the affected side. They may also want to search for trigger points along the SCM and scalenes at this time. Loosening these muscles will help restore mobility of the clavicle if not reduce the pain. Additional treatment and prevention Includes NSAIDs and ice for pain management and to help reduce inflammation and swelling. This injury is most common among football players, bicyclists, and skiers. Sprains or strains of the SCM usually occur at the insertion, causing tension throughout the muscle’s length. Massage therapists should treat the insertion with cross-fiber friction, and the rest of the muscle with directional massage, myofascial release, stretches, and trigger point therapy. Note that doing direction massage and myofascial release will be done from insertion towards origin with this muscle and that because of this muscle’s proximity to the trachea (windpipe), it can be uncomfortable for the athlete. Trigger point therapy (if trigger points are indicated by pain behind or in the ear, or by pain just above the eyebrow) can be done by pinching the SCM between the thumb and fingers and drawing the SCM away from the trachea which may be a slightly more comfortable approach to an SCM injury. Passive stretches are most suitable for stretching the SCM; therapists should avoid AC and CRAC stretches, as these techniques are often reported as being uncomfortable for SCM injuries. Next, the scalenes group (anterior, medial, and posterior scalene muscles) collectively originate from the transverse processes of C2 to C7 and insert onto the first and second ribs. An injury to one or more of the scalene muscles may be indicated by pain when flexing the neck to the same side as the scalenes,
EliteLearning.com/Massage-Therapists
Book Code: MTX1323
Page 78
Powered by FlippingBook